Publication:

Combination of foley catheter and vaginal misoprostol compared with vaginal misoprostol alone for cervical ripening and induction of labour

Background Induction of labour in women with an unfavourable cervix remains a common obstetric challenge. The addition of a transcervical Foley catheter may enhance cervical ripening through mechanical dilatation and endogenous prostaglandin release, thereby improving labour outcomes. This study compared the effectiveness and safety of Foley catheter combined with vaginal misoprostol versus vaginal misoprostol alone for cervical ripening and induction of labour in term pregnancies.

Methods This prospective, comparative, hospital-based interventional study included 50 women with singleton term pregnancies, vertex presentation, intact membranes, and Bishop score ≤5. Participants were randomly allocated to vaginal misoprostol alone (n=25) or Foley catheter combined with vaginal misoprostol (n=25). Induction outcomes, mode of delivery, and neonatal outcomes were compared.

Results The combination group had a significantly shorter induction-to-delivery interval (15.3±6.5 vs. 18.3±8.7 hours; p=0.03) and time to complete cervical dilatation (13.7±5.9 vs. 17.1±8.7 hours; p=0.03). Delivery within 24 hours was higher with combination therapy (80% vs. 64%). Birth weight, Apgar scores, and neonatal intensive care unit admissions showed no significant differences.

Conclusions Foley catheter combined with vaginal misoprostol effectively shortens labour induction without increasing maternal or neonatal complications and is a safe alternative to vaginal misoprostol alone.